Even after tremendous growth of the healthcare industry in India, there are as many as 98,000 patients succumbing to death every year due to medical errors. More than 20 per cent could have led a comfortable life if not for that one gross medical negligence.
Thirty seven per cent patients were children below 15 years of age while 11 per cent were senior citizens with perfect health conditions (A study by the National Board of Hospitals and Healthcare Providers (NBH&HP) in February 2014). Yes, medical errors are a reality and have to be rooted out of the system. We need better management and quality control.
Quality control practice is an inherent requirement of each and every sector, it applies to the healthcare domain as well to determine and channelize a proper delivery system. Error specifically indicates any defect from process followed, documentation, inventory management, laboratory tests and eventually reporting and interpretation of results. These errors cumulatively result in serious consequences. Healthcare is a highly complex route. It has been striving for continuous improvement in quality and process streamlining.
Growing body of evidences which have been accumulating since years suggests that quality of healthcare practices cannot be judged alone by the analytical methods used for treating and handling. The absence of focus on emergency care, missing trained nurses, lack of management capacity in health system and absence of comprehensive medical services can be attributed to severe medical negligence.
Also errors in lab are very common. They mainly occur in three stages: pre-analytics, analytics and post analytics. The first one being the pre-analytical stage which involves sample collection, sample transport and sample receipt. The second phase deals with test evaluation and quality control testing. The last stage deals with record keeping and reporting. Samples can get contaminated — either in the hospital or en route to the testing facility. A breakdown in effective communication between lab facilities and medical providers results in errors in either testing or the reporting of results.
So quality management and control is necessary for hospital to devise reliable and efficient treatment procedure. Hospitals should consider adopting Total Quality Management (TQM) as a framework and a way to operate with the aim for integration, consistency, and increase in efficiency and a continuous drive for improvement.
TQM which encompasses various quality check protocols for example: Total quality control, total quality leadership, continuous quality improvement, and quality management science. Quality systems are undergoing tremendous transformation in present decade in Healthcare Organizations. There are various tools that are used in health care industry for quality control and quality management.
Lean practices can also be used to improve the quality of service at the hospital. Lean will focus on improving quality and thus improve overall hospital performance.
Organizational and structural changes such as establishment of quality-related councils and committees, empowerment of nurses and other staff, and investments in new technology and infrastructure facilitates better outcomes. Error proofing technique like Poka-yoke is an extensively used tool, which helps in the implementation of Zero Quality Errors.
The Poka-Yoke technique can be applied both to prevent causes, which will result in subsequent occurrences of errors and to carry out low-cost control determining whether to adopt or reject the particular analysis method.
Documentation of errors heightens the awareness of problems and offers the chance to expose and resolve recurrent sources of error. Structured Problem Solving frameworks like 8D methodology hold good for healthcare institutions as well.
An effective integration of error proofing and quality management will allow the healthcare setup to identify, control and decrease error rates. This won’t stand in place until various factors like intra departmental co-operation followed by proper communication is achieved.
Quality Management practices in Indian healthcare industry can not only lead to great patient care but better economics for the organization.